title: Respiratory infections in Eñepa Amerindians are related to malnutrition and Streptococcus pneumoniae carriage.
abstract: OBJECTIVE
  High acute respiratory tract infection (ARTI) rates are observed in indigenous populations. We assessed the role of viral infections and nasopharyngeal bacterial carriage in ARTIs in Eñepa Amerindians from Venezuela.
  
  
  METHODS
  In 40 children aged 0-10 years with ARTIs, healthy nearest-age sibling controls and their mothers the presence of Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Moraxella catarrhalis, Mycoplasma pneumoniae, Chlamydophila pneumoniae/psittachi and 15 respiratory viruses was investigated.
  
  
  RESULTS
  S. pneumoniae was the most frequently detected pathogen, with carriage rates of 75% and 38% in children and mothers respectively. In children, S. pneumoniae carriage was associated with ARTI risk in multivariate analysis (OR 14.1, 95% CI 1.4-137.7). Viral infections were not associated with ARTI risk. S. pneumoniae carriage was common in children of all ages while viral co-infections were more frequently present in children under 4 years compared to older children (46% vs. 17%, p < 0.01). An increase of one unit height-for-age Z score (i.e. improved chronic nutritional status) was associated with decreased odds of S. pneumoniae colonization in multivariate analysis (OR 0.66, 95% CI 0.44-0.99).
  
  
  CONCLUSIONS
  In Eñepa children high S. pneumoniae carriage rates associated with a poor nutritional status contribute to the development of ARTIs.
authors.affiliation: Laboratory of Pediatric Infectious Diseases, Radboud University Medical Centre, PO Box 9101 (Internal Post 224), 6500 HB Nijmegen, The Netherlands.
authors.forename: Lilly M
authors.initials: LM
authors.lastname: Verhagen
authors.forename: Keyla
authors.initials: K
authors.lastname: Gómez-Castellano
authors.forename: Eveline
authors.initials: E
authors.lastname: Snelders
authors.forename: Ismar
authors.initials: I
authors.lastname: Rivera-Olivero
authors.forename: Leonor
authors.initials: L
authors.lastname: Pocaterra
authors.forename: Willem J G
authors.initials: WJ
authors.lastname: Melchers
authors.forename: Jacobus H
authors.initials: JH
authors.lastname: de Waard
authors.forename: Peter W M
authors.initials: PW
authors.lastname: Hermans
mesh_terms: D001424:Bacterial Infections / Q000150:complications* / Q000382:microbiology; D002353:Carrier State / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D044342:Malnutrition / Q000150:complications*; D009305:Nasopharynx / Q000382:microbiology*; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology; D014687:Venezuela; D014777:Virus Diseases / Q000453:epidemiology* / Q000821:virology
keywords: Amerindians; Bacteria; Child; Nasopharynx; Respiratory tract infections; Viruses